A network rallies for new antibiotics

Kevin Outterson's first phone call was to John H. Rex, a leader in antibiotic drug development, who is a senior vice president at AstraZeneca Pharmaceuticals and a colleague from Outterson's antibiotic resistance policy work for the European Union.

It was the end of February 2016. The Biomedical Advanced Research and Development Authority (BARDA) had just announced a $250 million grant opportunity to establish a novel partnership to accelerate the preclinical development of new antibiotics.

Outterson, a professor of law, wanted to put together a trans-Atlantic team of leading scientists, biotech innovators, and major funders with an unusual decentralized structure that would spur innovation without adding layers of bureaucracy—and apply for the grant.

Would Rex join the team? The completed 50-page application was due in less than 60 days.

"When he proposed it, my jaw sort of hit the floor," says Rex. "As I listened to Kevin, I thought it was a brilliant idea."

BARDA was especially interested in applicants who could come in with significant additional funds. "Wellcome Trust was at the top of our list and John had been working with them for several years on drug innovation," Outterson says. "I got on a plane to London." He joined Rex at a meeting at the global foundation's London headquarters.

"They had been in the process of a strategic review of how they funded biomedical R&D," Outterson says. "Our discussions were amazingly fruitful."

Outterson and Rex left that meeting, on March 8, 2016, with nothing more than a handshake, but by April 15, Wellcome Trust had not only signed a commitment letter, they had recruited another major partner, the AMR Centre, a new UK government-sponsored public-private initiative to develop antibiotics and diagnostics. The AMR Centre would provide $100 million over five years for Outterson's proposed accelerator while Wellcome would supply "further funding."

Outterson and Rex also signed on as partners biotech accelerators from two of the world's hottest life science innovation hubs—the Massachusetts Biotechnology Council in Cambridge and the California Life Sciences Institute in San Francisco.

Outterson reached out to Deborah Hung, who co-directs the Broad Institute's infectious disease program. "He asked me, 'What is the biggest problem that gets in the way of innovation in antibiotic resistance and drug discovery being developed into translational reality?'" recalls Hung. "We had a discussion about how you would bridge the gap."

Hung's answer to the question was the Broad's new interdisciplinary Collaborative Hub for Early Antibiotic Discovery (CHEAD), which will offer its expertise in such areas as medicinal chemistry, pharmacokinetics, and analytical screening to CARB-X grantees.

This is how the BU School of Law, and Outterson, won one of the largest biomedical research grants the federal government has awarded in recent years—and one of the largest in BU history.

Gloria Waters, BU's vice president and associate provost for research, says, "Kevin has the best Rolodex of anyone in antibiotics. He knows everybody in this field. He deserves a lot of credit for having the vision and the courage to undertake this extremely ambitious project. He was working under incredible deadline pressure and managed to get the necessary people on board to pull off a winning proposal in record time."

"Relationships really matter when you want to build something innovative," Outterson says. He credits the connections he made during his 2014 sabbatical at Chatham House, an independent policy institute in London, and through DRIVE-AB—Driving Reinvestment in R&D and Responsible Antibiotic Use—a public-private consortium funded by the European Union's Innovative Medicines Initiative.

"It's really not about me," says Outterson, who was a founding member of the CDC's Working Group on Antimicrobial Resistance in 2011. "It's about the network of people who understand the complexity of this problem and have worked together in various projects over the past decade."

"One of the good things about this [CARB-X]," says Rex, "is that the executive director—Kevin—is not in the game the way the rest of us are. He's able to see things from a different viewpoint."

Before becoming a law professor, Outterson, who graduated from the Northwestern University School of Law and the University of Cambridge in England, was a partner in two major corporate law firms, working on complex transactions.

"Kevin's specialty was deals no one else could get done," says Rex. "His consummate skill, deep down, is getting people to do complicated deals, to work together."

Provided by Boston University